Nokea
Toxic shock syndrome:
- A. will often manifest without fever
- B. is a misnomer because BP is often maintained
- C. is caused by pseudomonas species
- D. often produces elevated creatinine kinase
Correct Answer: D
Rationale: TSS fever burns, BP drops, staph rules, CK jumps, rash spreads. Nurses clock this chronic toxin surge.
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Which of the following is NOT an example of intermittent fasting?
- A. Alternate day fasting
- B. Mediterranean dieting
- C. Modified fasting regimes such as the 5:2 diet'
- D. Time restricted feeding
Correct Answer: B
Rationale: Fasting flips alternate, 5:2, timed, holy skips; Mediterranean's steady, not starved. Nurses clock this chronic fast gap.
Which of the following clients would not be a candidate for thrombolytic therapy?
- A. Client with a pulse of 102 beats/minute
- B. Client with a blood pressure of 100/60 mm Hg
- C. Client with a history of hemorrhagic stroke one month ago
- D. Client age 65 years
Correct Answer: C
Rationale: Thrombolytics bust clots but bleed big hemorrhagic stroke history, even a month back, bans them, as re-bleed risk soars, a firm no-go. Tachycardia, low BP, or age 65 don't nix it BP's workable, age isn't a cutoff. Nurses screen this, dodging brain bleeds, a safety lock in this clot-dissolving call.
The nurse is discharging home a client at risk for venous thromboembolism on enoxaparin sodium. What instruction is a priority for the nurse to provide to this client?
- A. Notify your health care provider if your stools appear dark or tarry
- B. You must have your prothrombin time (PT)/international normalized ratio (INR) checked every 2 weeks
- C. Massage the injection site after the heparin is injected
- D. You must have your activated partial thromboplastin time (aPTT) checked every 72 hours
Correct Answer: A
Rationale: Enoxaparin, a low-molecular-weight heparin, thins blood dark, tarry stools signal GI bleed, a dire side effect needing instant reporting to halt hemorrhage. PT/INR tracks warfarin, not enoxaparin; aPTT's for unfractionated heparin. Massaging injection sites risks bruising. Nurses prioritize bleed watch, ensuring safety on this clot-busting med, a discharge must-know.
What is the essence of motivational interviewing?
- A. That change strategies must exactly match the patient's motivation
- B. That behavioural change is impossible if the patient does not want it
- C. That the counsellor motivates the patient to change and increases patient involvement
- D. That the patient's motives to show unhealthy behaviour are systematically analysed
Correct Answer: C
Rationale: Motivational interviewing counsellor sparks, pulls patients in, not rigid matches, impossibles, or motive digs. Nurses roll this, a chronic engagement art.
Appropriate statements regarding markers of outcome after major surgery in England in 2014 include:
- A. Data about each hospital's complication rates after surgery are readily available.
- B. Data about each hospital's 30-day mortality after surgery are readily available.
- C. For most procedures, 90-day mortality rate are similar to 30-day mortality rates.
- D. National Hospital Episode Statistics (HES) data are useful for monitoring the performance of units.
Correct Answer: B
Rationale: In 2014 England, surgical outcome transparency increased. Complication rates weren't universally published per hospital, varying by procedure and trust. However, 30-day mortality data were widely available, notably via NHS initiatives and specialty audits (e.g., National Joint Registry), reflecting short-term success. Ninety-day mortality often exceeds 30-day rates (e.g., in vascular surgery), capturing delayed deaths, so they're not typically similar. HES data, capturing inpatient episodes, help monitor trends and performance, though coding accuracy limits granularity. Weekend admission mortality was higher, per studies like 2015 BMJ, due to staffing and care differences. The availability of 30-day mortality data was a key quality metric, driving accountability and improvement in surgical care.